kamlya balgoon 2009 av blocks av block occur when the conduction of impulse through av node...
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Kamlya balgoon2009
AV BlocksAV block occur when the conduction of
impulse through AV node decrease or stop Prolonged P-R interval or more P waves
than QRSBlock means DELAY.
Causes Medication heart & valvular disease
kemo 2009
1 -1st Degree AV BlockIt artial impulse conduct through AV node
into ventricle are rate slower than normal It looks like the sinus rhythm but with
prolonged P-R interval..Normal and identical P waves. Each P is Followed by a QRSNormal QRS.P-R interval is 0.20 sec or moreP: QRS ratio : 1 :1
Prolonged P-R intervalkemo 2009
2 -2nd Degree AV Block a- Mobitz I Normal QRS. Identical P waves. P-R interval progressively prolongs
until there is P not followed by a QRS
P without QRS
kemo 2009
2 -2nd Degree AV Block a- Mobitz II
Identical P waves, Not every P is followed by a QRS.
When there is a QRS, it has to be preceded by a P wave
Atrial rate is regular.Check BP immediately.
Every QRS preceded by a P waves
Identical P waves
kemo 2009
4- 3rd Degree AV Block( Complete Heart Block )
No relationship between P waves and QRS complexesCheck the BP immediately
kemo 2009
ECG: changes in heart rate, rhythm.*Blood chemistry: electrolyte imbalance.Nursing intervention:Monitor pulse for irregular pattern or abnormally rapid or slow rate.Observe for arrhythmiascontinuous cardiac monitoring.Assess cardiovascular, respiratory, and neurovascular status.
Possible diagnostic findings
kemo 2009
Initiate cardiopulmonary resuscitation (CPR), if indicated, until other advanced cardiac life support
measures are available and successful.
Perform defibrillation early for ventricular tachycardia and ventricular fibrillation.
kemo 2009
Nursing intervention
Nursing interventionAdminister medications, oxygen, and I.V
fluids, as needed.Prepare for procedures, such as
cardioversion Monitor for predisposing factors (such as
fluid and electrolyte imbalance) and signs of drug
toxicity, especially digoxin. Monitor and record vital signs.Maintain prescribed diet.Maintain bed rest, until patient is stable.Provide support to the patient and family. kemo 2009
Sinus Rhythm ( the only normal one )
Heart rate rhythmP waveP r interval In second
QRS in second
Rate 60-100 b/pm
RegularNormal identical P waves
0 ,12 to 0,20 seconds
second 0,12
Sinus arrhythmia or sinus block
Heart rate rhythmP waveP r interval In second
QRS in second
Rate 60-100 b/pm
irregular rhythm
Normal identical P waves
0,12 to o,20 second
o,20 second Normal
A total beat missed
Premature A trial Complex ( PAC)
Heart rate rhythmP waveP r interval In second
QRS in second
depend on underlying rhythm
irregular rhythm
different p wave , hidden in T wave
0 ,12 to 0,20 second
Normal, ubnormal 0,12
Premature Ventricular Contraction ( PVC )
Heart Rate rhythmP waveP r interval In second
QRS in second
depend on rhythm
irregular visibility p wave depend time of PVC may absent or in front QRS
less than 0,12 second
duration 0.12 second or more . Bizarre , abnormal shape
PVCs (early,
wide and bizarre)
Premature Ventricular Contraction ( PVC )
Heart Rate rhythmP waveP r interval In second
QRS in second
depend on rhythm
irregular visibility p wave depend time of PVC may absent or in front QRS
less than 0,12 second
duration 0.12 second or more . Bizarre , abnormal shape
Multifocal ( different shape )
Premature Ventricular Contraction ( PVC )
Heart Rate rhythmP waveP r interval In second
QRS in second
depend on rhythm
irregular visibility p wave depend time of PVC may absent or in front QRS
less than 0,12
second
duration 0.12
second or more .
Bizarre , abnormal
shape
Unifocal
Premature Ventricular Contraction ( PVC )
Heart Rate rhythmP waveP r interval In second
QRS in second
depend on rhythm
irregular visibility p wave depend time of PVC may absent or in front QRS
less than 0,12 second
duration 0.12 second or more . Bizarre , abnormal shape
Couplets
Premature Ventricular Contraction ( PVC )
Bigeminy :-every other beat is PVC
Heart Rate rhythmP waveP r interval In second
QRS in second
depend on rhythm
irregular visibility p wave depend time of PVC may absent or in front QRS
less than 0,12 second
duration 0.12 second or more . Bizarre , abnormal shape
Premature Ventricular Contraction ( PVC )Trigeminy :- every third complex is PVC
Heart Rate rhythmP waveP r interval In second
QRS in second
depend on rhythm
irregular visibility p wave depend time of PVC may absent or in front QRS
less than 0,12 second
duration 0.12 second or more . Bizarre , abnormal shape
(Asystole (
kemo 2009
Heart Rate rhythmP wavePR interval In second
QRS in second
No heart rate
irregularNo P wave NoNo QRS.
1 -1st Degree AV BlockAV block occur when the conduction of impulse
through AV node decrease or stop Prolonged P-R interval
kemo 2009
Heart Rate rhythmP wavePR interval In second
QRS in second
Depend on rhythm
Depend on rhythm
sinus rhythm , regular shape
P-R interval is 0.20 sec or more
Normal QRS.
2 -2nd Degree AV Block a- Mobitz IP without QRS
kemo 2009
Heart Rate
rhythmP wavePR interval In second
QRS in second
Depend on rhythm
sinus rhythm but with prolonged P-R interval
Shape depend on rhythm
P-R interval progressively prolongs until there is P not followed by a QRS
Normal QRS.
2 -2nd Degree AV Block a- Mobitz II
Every QRS preceded by a P waves
Identical P waves
kemo 2009
Heart Rate rhythmP wavePR interval In second
QRS in second
Depend on rhythm
irregularIShape depend on rhythm
P-R interval is 0.20 sec or more
a QRS, it has to be preceded by a P wave .
3rd Degree AV Block( Complete Heart Block )
Heart Rate rhythmP wavePR interval In second
QRS in second
Depend on escape & artial rhythm
sinus rhythm , irregular
Depend on rhythm
Very irregular
More p wave than QRS.
kemo 2009